Medicare Compliance Review of Saint Louis University Hospital for 2011 and 2012

Saint Louis University Hospital (the Hospital) (operating in Saint Louis, Missouri) complied with Medicare billing requirements for 243 of the 261 outpatient and inpatient claims we reviewed. However, the Hospital did not fully comply with Medicare billing requirements for the remaining 18 claims, resulting in net overpayments of $119,000 for calendar years 2011 and 2012. Specifically, 4 outpatient claims had billing errors, resulting in overpayments of over $65,000, and 14 inpatient claims had a billing error, resulting in net overpayments of over $53,000. These errors occurred primarily because the Hospital did not have adequate controls to prevent the incorrect billing of Medicare claims within the selected risk areas that contained errors.